Baby Teeth – Tiny Eruptions
Almost like clockwork, infants start drooling at about 4 months of age. Many times, parents assume this means new teeth will be popping through those delicate gums at any moment. This may or may not be true, depending on the baby. There is a large range of “normal” for teeth to erupt, anywhere from 4-12 months old. Each baby’s time line is different, even siblings can be very different in timing of the first tooth.
Instead, drooling should be viewed as a developmental milestone. It begins when the infants start to experience the world through their mouths – they suddenly have the ability to bring hands and feet to the mouth, bring objects into the mouth, and usually are beginning to experience solid or pureed foods as well. Saliva works to keep infants’ mouths moist and make it easier to swallow, helps to wash away food residue (and germs), contains digestive enzymes, and protects against tooth decay.
Tooth Eruption
The first teeth to erupt are usually the front lower teeth, followed by the front upper teeth. These teeth are also called central incisors. Occasionally infants will have the teeth just to the sides of the central incisors (called lateral incisors) erupt first, but this is much less common. Most children have all of their baby teeth by age 3.
Gums typically become swollen and tender. Sometimes purplish bumps called “eruption cysts” occur, but these are not concerning.
Teething Pain
Pushing a tooth through the gums is sometimes a painful experience. Infants who are teething can be more fussy, can drool even more profusely, and can have difficulty eating or sleeping normally. A common misconception is that teething causes fever – this is not true. If your infant has a fever and is fussy, he or she should be seen by the Pediatrician.
While most infants handle teething without needing much intervention, the following can help if they are uncomfortable:
- Massaging gums with a clean finger
- Occasional doses of acetaminophen
- Solid teething rings to chew on
- Cold cloths to chew on
There are a lot of products out there for teething, and unfortunately not all are helpful or recommended, and some can be dangerous. The American Academy of Pediatric recommends avoiding the following:
- Teething tablets or gels, particularly those that contain the ingredients Belladonna and Benzocaine. Belladonna is a poisonous chemical found in plants. Benzocaine is a chemical that causes numbness. The FDA has issued warnings against both of these ingredients.
- Amber teething necklaces. These have become very popular, with marketing claims that the amber beads release pain relieving substances, stimulate the thyroid gland, and improve immune system ability. However, these necklaces pose both strangulation risks and choking hazards to infants and toddlers. Additionally, there has been no scientific research that supports the manufacturer’s claims.
Prevention of Tooth Decay
It is incredibly important to make prevention of tooth decay a priority for baby teeth. Brushing teeth before bedtime should start as soon as the first teeth erupt. Avoid allowing breastmilk or formula to sit in the mouth overnight, which happens either through drinking to fall asleep or drinking throughout the night.
I discuss taking care of little teeth further in a previous blog post: Taking Care of Little Teeth
Final thoughts
Few things are cuter than an infant with two tiny teeth visible in a gummy smile. The eruption of the first tooth is one of the milestones parents focus on the most. Teething can be simple or it can be prolonged and painful, and there are specific recommendations to making this process easier for infants and toddlers. Once those tiny teeth are through, it is important to take care of them and prevent tooth decay.
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